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Full text of "Spread the Word about Mammograms and the Pap Test: An Education Resource for Health Care Professionals"

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Mammograms 



and the 



Pap Test 

An Educational Resource For Health Care Professionals 



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NATIONAL INSTITUTES OF HEALTH 
National Cancer Institute 



OMH-RC-Knowledge Center 

5515 Security Lane, Suite 101 

Rockville, MD 20852 

1-800-444-6472 



The National Cancer Institute (NCI) commends your efforts to educate 
women about the importance of early cancer screening. To assist you, NCI is 
pleased to provide Spread the Word about Mammograms and the Pap Test: An 
Educational Resource for Health Care Professionals. 

Using simple pictures and words, these flip charts illustrate many of the 
key messages that help women understand the importance of early cancer 
detection. Talking points that can be addressed while presenting the 
information are included. Two reproducible NCI pamphlets entitled 
1) Mammograms: Not just once, but for a lifetime; and 2) Pap Tests: A Healthy 
Habit for Life are also included. Please feel free to photocopy the 2-sided 
easy-to-read pamphlets and distribute them to the women who attend 
your presentation. 

Community health educators can present these flipcharts to small groups 
that are no larger than 10 people. The breast cancer flip chart is for women in 
their 40s or older and the cervical cancer for women age 18 or older (or 
younger who are sexually active) as well as for women age 65 or older. 

An evaluation form is enclosed, please let us know how your presentation 
goes. Your comments will help us make NCI's cancer screening education 
efforts more effective. If you would like more information about breast 
and/or cervical cancer, please call NCI's Cancer Information Service at 
1-800-4-CANCER. 



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TALKING POINTS: 

• Today I'd like to talk to you about how important it is to 
get mammograms regularly. 

• A mammogram is an x-ray picture of your breast that 
can help find breast cancer before you or your doctor 
can feel it. 

• It is one of the most important things a woman 
in her 40s or older can do for herself. 



• Get mammograms every one to two years and help 
spread the word to your mother, sisters, daughters, and 
friends about this test. 




TALKING POINTS: 

• You may think you don't need a mammogram. You do, 
especially if you're in your 40s or older. 

• The older you get, the greater your chances of getting 
breast cancer. 

• It is important for all women age 40 or older to have 
a mammogram and clinical breast exam every one to 
two years. If every woman 40 and older had these 
exams on a regular basis, the death rate from breast 
cancer would drop. 



How many of you know a woman who has had breast 
cancer? 



Breast cancer is one of the most common cancers found 
in women in the United States. 



Breast cancer 
is one of the 
leading causes 
of cancer death 
in women in the 
United States. 





TALKING POINTS: 

• Here are some tips to help you get ready for your 
mammogram. 

• If you are still having your periods, make your 
appointment for the week after it ends. During your 
period, your breasts may be tender, and the 
mammogram could be somewhat painful. 

• On the day of the exam, don't put any deodorant, 
perfume, powder, or lotions on or around your breasts 
or underarms. Any of these can make your x-ray look 
suspicious. 



Wear clothes like a blouse or sweater with pants or a 
skirt, which make it easy for you to undress from the 
waist up. 



Bring any information about other mammograms or 
breast treatments you've had, and the phone number 
and address of your doctor so that your results can be 
sent to him or her. 



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Some tips 
to help you 
get ready 
for your 
mammogram 



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Getting a 
Mammogram 




TALKING POINTS: 

• Getting a mammogram is easy. It takes only a few 
minutes. 

• You'll stand in front of a special x-ray machine and a 
trained technologist will place your breast on a small 
plastic tray. Another plastic tray is placed on top. 
For a few seconds, pressure is applied to flatten your 
breast while the x-ray is taken. 

• The purpose of flattening your breast is to spread it out 
so that any lumps or breast changes are easier to see. 

• The technologist will take two pictures of each 

of your breasts, one from the top and one from the side. 

• The x-ray is given to a doctor called a radiologist who 
looks for signs of breast cancer or other problems. 
The radiologist will report the results to your doctor, 
who will then contact you. 

• If you don't receive the results within a week, call your 
doctor or the mammography facility and ask for the 
report. 



How many of you have had a mammogram in the last 
year? Let's talk about what was positive about the 
experience. 



Getting a 
Mammogram 



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Examples of Unusual 
Breast Changes: 

• a change in the size or 
shape of your breast 

• a lump or thickening 
of your breast or 
underarm 

• breast skin changes 

• nipple thickening 
or discharge 



TALKING POINTS: 

• There are two types of mammograms: screening 
mammograms and diagnostic mammograms. 
Let's talk first about diagnostic mammograms. 

• A woman gets a diagnostic mammogram when she has 
symptoms of breast cancer, like a change in the size or 
shape of her breast, a lump or thickening of her breast 
or underarm, breast skin changes, or nipple thickening 
or discharge. 



• Women who have any unusual changes to their breasts 
need to see their doctor as soon as possible. 

• Most often, these changes turn out not to be cancer; 
but it is important to do the necessary tests to 
make sure. 



What we want to talk about today are screening 
mammograms-for women without symptoms of 
breast cancer. 



Examples of Unusual 
Breast Changes: 

• a change in the size 
or shape of your 
breast 

• a lump or thickening 
of your breast or 
underarm 

• breast skin changes 

• nipple thickening 
or discharge 



How much does 
a screening 
mammogram 
cost? 




TALKING POINTS: 

• A screening mammogram generally costs between $50 
and $150. 

• Mammograms are often paid for by private 
insurance or by Medicare. 

• There are some community groups that give free 
mammograms and some programs that charge you 
based on your income. 



• How many of you use your Medicare benefits to pay 
for your mammograms? 

• Medicare helps pay for the cost of one screening 
mammogram every year (that is, 12 calendar months 
from the time of the last mammogram). 



For information about Medicare coverage, you can call 
the Medicare Hotline at 1-800-Medicare (1-800-633-4227). 



How much 
does a 
screening 
mammogram 
cost? 





Ask your doctor 
to send you for 
a mammogram. 



TALKING POINTS: 

• Ask your doctor when you should start having 
mammograms and how often you need to have them. 
Decide on a plan with your doctor and follow it for the 
rest of your life. 

• Your doctor's office can make the appointment. Or, you 
can make it yourself if the mammography facility you 
choose gives mammograms without a doctor's referral. 

• Today, all mammography facilities must be certified by 
the Food and Drug Administration. This means that they 
all must meet the same quality standards for the equip- 
ment they use, the people who work there, and the 
records they keep. 

• You can call the National Cancer Institute's Cancer 
Information Service at 1-800-4-CANCER to find out where 
to get a mammogram near your home. 

• How many of you have a doctor who refers you for 
mammograms regularly? 



Don't wait for your doctor to bring it up. Ask your 
doctor to send you for a mammogram. 




Ask your 
doctor to 
send you 
for a 
mammogram. 



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Get a clinical breast 
exam once a year. 





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TALKING POINTS: 

• It is also important for all women to have a clinical 
breast exam on a regular basis. 

• When you have a regular check up, your doctor will 
give you a clinical breast exam. During this exam, your 
doctor will look at and feel for lumps in your breasts, 
underarms, and even your collarbone area. 

• Many women may also choose to do a monthly breast 
self-exam to become familiar with the normal texture of 
their breasts. Remember a breast self-exam is never a 
substitute for regular screening mammograms for 
women in their 40s or older. 



Get a clinical 
breast exam 
once a year. 



/ 




[Some audiences have special concerns, 
including language and cultural barriers — 
listen to their concerns and include them 
as examples in future presentations of 
this flip chart] 



TALKING POINTS: 

• There are some common concerns that keep women 
from having mammograms. 

• "I'm afraid I'll get too much radiation." With modern 
mammography equipment, only a small amount of 
radiation is used. 

• "A mammogram is painful." Some women experience 
discomfort during a mammogram. The actual time when 
the breast is pressed against the plastic tray is only a 
few seconds. The compression is needed to get a clear 
x-ray of the breast. 

• "I don't need a mammogram unless I feel a lump in my 
breast." The benefit of mammography is that it can find 
breast cancer and other breast changes before you or 
your doctor can feel them. 

• "If I have breast cancer, I don't think I can face it. 

I don't want to know." If breast cancer is found early 
and has not spread, the chances of successful treatment 
and surviving are very good. 

• "Mammograms don't always find breast cancer." No 
medical test is 100% accurate, some breast changes 
don't show up on a mammogram. That is why it is 
important to have a clinical breast exam once a year. 

• Do any of you know of other concerns a woman might 
have to keep her from having a mammogram? 



Some common 
concerns about 
mammograms 




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TALKING POINTS: 

• Simply being a woman and getting older puts you at 
some risk for breast cancer. Most breast cancers occur 
after age 40. 

• Your risk for breast cancer continues to increase over 
your lifetime. 

• Most women who get breast cancer have no known 
risk factors, such as family history of the disease. 



Talk to your doctor about the risk factors for 
breast cancer. 



Will I get 

breast 

cancer? 




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TALKING POINTS: 



Cancer 
Institute 



Cancer Information Service 

1-800-4-CANCER 

(1-800-422-6237) 



• For more information about breast cancer and 
mammograms, or to find a mammography facility in 
your area, call the National Cancer Institute's Cancer 
Information Service at 1-800-4-CANCER (1-800-422-6237). 

• CIS offices are open Monday through Friday, 9 a.m. to 
4:30 p.m., local time. 

• Trained cancer information specialists will answer 
your questions in English or Spanish and send you free 
publications. 



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Cancer Information Service 

1-800-4-CANCER 
(1-800-422-6237) 



TALKING POINTS: 



Mammograms: 

Not just once, 

but for a 

lifetime. 



• Those of you who have had a mammogram are off to a 
good start, but once is not enough. Cancer can start to 
grow at any time. 

• Regularly scheduled mammograms are the best way of 
finding breast cancer early. 



Don't take chances with your health. Make an 
appointment for a mammogram soon. 



Mammograms: 

Not just once, 

but for a 

lifetime. 







Help spread 
the word about 
mammograms! 



TALKING POINTS: 



Any questions? 



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Help 
spread 
the word 
about 
mammograms! 



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P^p Test 




TALKING POINTS: 

• Like most women today, you have a lot to think about, 
like caring for your family and your home, and your job. 

• These demands make it easy for you to neglect your 
own needs, especially when it comes to your health. 

• Women need to take the time to take care of their own 
bodies and health. It is the best choice they can make 
for their families. 

• One way to do this is to look for cancer early or get 
cancer screening. 



Today I'd like to talk to you about one kind of cancer 
screening, a Pap test for cervical cancer. 




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Cervical Cancer is one of the most 
common cancers found 
in women in the U.S. 




TALKING POINTS: 

• Some of you may know a woman who has had cervical 
cancer because it is one of the most common cancers 
found in women in the United States. 

• A woman can have cervical cancer and not know it 
because she may not have any symptoms. 



Cervical cancer is one of the most 
common cancers found 
in women in the U.S. 



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TALKING POINTS: 

• The uterus or womb is located below your stomach. 

• The cervix is located in the lower portion of the womb. 

• The cervix opens into the vagina which leads to the 
outside of the body. 




Female 

Reproductive 

System 

uterus 
cervix 
vagina 




TALKING POINTS: 

• Cervical cancer happens when abnormal cells begin to 
grow in the cervix. 

• Finding and treating abnormal cells is important. 

If these cells are not treated, they can become cancer. 

• There is a simple and safe screening test that you can 
get that can find abnormal cells in and around the 
cervix. This test is called the Pap test or Pap smear. 



A pap test should only take about one minute. 




TALKING POINTS: 

• You should have this test when you are not having your 
period. 

• For about 2 days before a Pap test, you should not 
douche or use birth control foams, creams, or jellies or 
vaginal medicines (except as directed by your doctor). 

• If you do use any of these, they might hide any 
abnormal cells. 



If you feel more comfortable being examined by a 
female doctor, ask if one is available. 



Some tips to help you get ready for a Pap test. 










TALKING POINTS: 











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Getting a 
Pap test 




A Pap test is done as part of a pelvic exam at your 
doctor's office. 

You will lie on your back on an exam table with your 
knees up and your feet placed in rests. 

To do the Pap test your doctor will use a special instru- 
ment called a speculum. 

The speculum is put into your vagina and opened up so 
that the walls of your vagina and cervix can be seen 
clearly. 





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Getting a 
Pap test 



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TALKING POINTS: 

• A small brush is used to collect a few cells from the 
cervix. 

• When the doctor takes the cells, you may feel a slight 
pinch. 

• The cells from the Pap test are placed on a glass slide, 
sprayed with a protective coating, and sent to a lab to 
be checked. This will tell if the cells in your cervix are 
normal or abnormal. 



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Cells are removed 
from the cervix. 



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Getting the 
results 




TALKING POINTS: 

• Most doctors or clinics will either send a letter or call 
you with your test results but some only contact you if 
there is a problem. You may wish to call the clinic and 
ask for the results. 

• If your results are abnormal, don't panic; most abnormal 
Pap tests are not cancer. You will need to return to the 
clinic soon for follow-up care. 

• Have any of you had a Pap test in the last year? 
What was positive about the experience? 



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Getting the 
Results 







How much 
does a Pap 
test cost? 




TALKING POINTS: 

• A Pap test costs between $60 and $150. 

• Pap tests are often paid for by private insurance. 

• Medicare covers the cost of a Pap test once every 
3 years. 

• There are some community groups that give free Pap 
tests and some programs that charge you based on your 
ability to pay. 



For information about Medicare coverage, you can call 
the Medicare Hotline at 1-800-Medicare (1-800-633-4227). 



How much 
does a 
Pap test 
cost? 




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Cervical cancer concerns all women. 




TALKING POINTS: 

• Women age 18 or older should have Pap tests regularly. 
Women younger than 18 need a Pap test if they are or 
have been sexually active. 

• It's also good to remember that Pap tests are still 
important even after you have reached menopause. 

• Women age 65 or older need to have Pap tests too. 
Encourage your mother, grandmother, sisters, aunts, 
and friends to be screened. 



• A woman who has had a hysterectomy (an operation 
to remove the uterus and cervix) should talk with her 
doctor about whether she needs to continue to have 
Pap tests. 



Cervical cancer concerns all women. 




TALKING POINTS: 



Pap tests: a healthy habit for life. 




• The Pap test gives you a chance to take control of your 
health. 

• Remember your own health needs as you meet all the 
challenges of caring for your family 

• A Pap test is an important way to take care of yourself 
and your future. 

• Do you think it is important for women to know about 
Pap tests? Why? 



Pap tests: a healthy habit for life 



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Make an 
appointment for 
a Pap test soon. 




TALKING POINTS: 

• Those of you who have had a Pap test are off to a 
good start. 

• Remember, regular Pap tests are the best way to find 
cervical cancer early, when it's most treatable. 

• Don't take chances with your health. Make an 
appointment for a Pap test soon. 



Make an appointment 
for a Pap test 



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TALKING POINTS: 



Cancer 
Institute 



Cancer Information Service 

1-800-4-CANCER 
(1-800-422-6237) 



• For more information about cervical cancer and 
Pap tests, call the National Cancer Institute's Cancer 
Information Service at 1-800-4-CANCER (1-800-422-6237). 

• Trained cancer information specialists will answer 
your questions in English or Spanish and send you 
free publications. 

• CIS offices are open Monday through Friday, 9 a.m. to 
4:30 p.m., local time. 



Cancer 
Institute 



Cancer Information Service 

1-800-4-CANCER 
(1-800-422-6237) 



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Cancer 
Institute 



September 1999